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Multicenter Prospective Evaluation of Radiofrequency for Anal Fistulas

Not Applicable
Completed
Conditions
Anal Fistula
Interventions
Procedure: treatment by radiofrequency
Registration Number
NCT03131297
Lead Sponsor
F Care Systems NV
Brief Summary

Anal fistula treatment is associated with increasing risk of anal incontinence until 40% of cases. New and alternative treatments (glue, advancement flap, plug...) decrease this risk, but with fistula efficacy treatment in 40 to 60% of cases. Radiofrequency might destroy fistula tract without lesion of anal sphincter.

Objective : Fistula healing rate and anal continence, 6 and 12 months after radiofrequency procedure.

Methods : Clinical and MRI evaluation before, 6 and 12 months after treatment. Patients : 50 patients with low, high, complex and Crohn disease fistula. An intermediate analysis is expected after the first 20 patients, to verify morbidity.

Evaluations :

* Fistula clinical healing 6 and 12 months after procedure

* Fistula MRI healing 12 months after procedure

* Anal continence before and after procedure

* Feasibility og radiofrequency procedure

* Morbidity

* Success and failure prognostics factors of this procedure

Detailed Description

: Anal fistula treatment is associated with increasing risk of anal incontinence until 40% of cases. New and alternative treatments (glue, advancement flap, plug...) decrease this risk, but with fistula efficacy treatment in 40 to 60% of cases. Radiofrequency might destroy fistula tract without lesion of anal sphincter.

Objective : Fistula healing rate and anal continence, 6 and 12 months after radiofrequency procedure.

Methods : Clinical and MRI evaluation before, 6 and 12 months after treatment. Patients : 50 patients with low, high, complex and Crohn disease fistula. An intermediate analysis is expected after the first 20 patients, to verify morbidity.

Evaluations :

* Fistula clinical healing 6 and 12 months after procedure

* Fistula MRI healing 12 months after procedure

* Anal continence before and after procedure

* Feasibility og radiofrequency procedure

* Morbidity

* Success and failure prognostics factors of this procedure

Schedule :

* First inclusion march 2017

* Last inclusion march 2018

* Evaluations until march 2019.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Adult Patient agreeing to participate in the study and signing the consent to participate
  • Patients with an anal fistula previously drained, without diverticulum> 10 mm in MRI after drainage.
  • For women of childbearing age, they must have a negative urine pregnancy test
Exclusion Criteria
  • Patient minor,
  • Patients who are linguistically or psychologically unable to understand the information given and to give informed consent,
  • Patient incapable, in the opinion of the investigator, to complete the self-questionnaires,
  • Against-indication to radiofrequency treatment (infectious anal pathologies, anal fissures, residual staples of previous treatment Longo,
  • Pregnant woman,
  • Patient carrying a pacemaker,
  • Patients participating in another clinical study,
  • Against indication to the realization of an MRI,
  • Patient with a fistula with insufficient drainage, against indicating the removal of the stem (congestive fistula, oozing, with internal and / or external congestive orifices).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Anal fistula treated by radiofrequencytreatment by radiofrequencytreatment by radiofrequency: patient with anal fistula treated by radiofrequency
Primary Outcome Measures
NameTimeMethod
Clinical healing of an anal fistula6 month

Clinical healing of an anal fistula, 6 months after radiofrequency treatment: A fistula is clinically healed if there is no drain, the external and internal openings are non-inflammatory, clogged, and without flow.

Secondary Outcome Measures
NameTimeMethod
evaluate anal continuation12 months

evaluate anal continuation with SELF-EVALUATION QUESTIONNAIRE

Determination of the optimal settings12 months

Evaluate the parameters of the probe (25 watts, 120 ° C, power 150 joules / 0,5 cm)

Assessment of Feasibility of anal fistula treatment by radiofrequencyday 0 at inclusion

Assessment of feasibility by measurement of anal fistula drying

Evolution in MRI12 month

If the MRI has eliminated an undrained pathway, a diverticulum greater than 10 mm, a hyper-intensity in T2 and after injection of Gadolinium.

Clinical healing of an anal fistula,12 months

Clinical healing of an anal fistula, 12 months after radiofrequency treatment: A fistula is clinically healed if there is no drain, the external and internal openings are non-inflammatory, clogged, and without flow.

Prognostic factors12 month

Evaluate the prognostic factors of good or bad response to this treatment: type of fistula, settings of the probe and the drying of the fistula

Patient satisfaction12 months

self-assessment questionnaire with numerical scales

the rate and nature of post-operative complications12 months

Number of Participants With Abnormal Values in MRI and Adverse Events That Are Related to Treatment

Trial Locations

Locations (4)

Clinique Blomet

🇫🇷

Paris, France

Chu Nantes

🇫🇷

Nantes, France

CHU Pontchaillou

🇫🇷

Rennes, France

Hopital Bagatelle

🇫🇷

Talence, France

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